Vascular endothelial growth factor and its receptor to diagnose lymph node metastasis in patients with oral cancer

目标。目的探讨血管内皮生长因子(VEGF)家族在口腔鳞癌(OSCC)中的临床意义。应用酶联免疫吸附试验检测129例新鲜口腔鳞状细胞癌患者术前血清中血管内皮生长因子家族(VEGF-A、-C、-D)及其受体(sVEGF-R1、sVEGF-R2)的水平。分析血管内皮生长因子家族与临床病理参数、治疗反应及预后的关系。口腔鳞癌患者血清中VEGF-A、-C、-D水平显著高于正常对照组，而sVEGF一R、sVFGF一R2值均无显著差异。在与健康对照组血清VEGF家族滴度95%分布范围比较的基础上，VEGF-A、-C和-D的阳性率分别为41、31和57%。血清血管内皮生长因子-A水平与性别、肿瘤大小、分期显著相关。VEGF-C浓度与远处转移显著相关，但与淋巴结转移无关。VEGF-C阳性组的5年生存率(63.2%)明显低于阴性组(83.5%，p&lt；0.05)。VEGF-D水平与淋巴结转移、侵袭方式呈负相关。采用免疫组织化学方法检测24例牙周癌组织中VEGF-C、Flt-4、CD34、CD31和D2-40的表达。VEGF-C和Flt-4的表达与淋巴结转移无关。免疫组织化学方法与血清学方法之间无相关性。血清VEGF-C水平可能作为口腔鳞癌的生物学标志物，但免疫组织化学方法与血清学方法之间的关系尚需更大范围的研究来证实

Objective. To evaluate the clinical usefulness of vascular endothelial growth factor (VEGF) family in patients with oral squamous cell carcinoma (OSCC).Methods. Preoperative serum values of VEGF family (VEGF-A,-C, and -D) and their receptor (sVEGF-R1,sVEGF-R2) were measured by enzyme-linked immunosorbent assay in 129 patients with fresh primary oral SCCs. The relationship among VEGF family, clinicopathological parameters, response to therapy and prognosis was investigated.Results. Serum VEGF-A,-C, and -D levels were significantly higher in patients with OSCC than in the healthy control, but both sVEGF-R1 and sVFGF-R2 were not. On the basis of comparision to the 95% range of distribution of serum VEGF family titers in healthy control subjects, the positivity rates of VEGF-A,-C and -D were 41, 31, and 57%, respectively. The serum level of VEGF-A correlated significantly with sex, tumor size and Stage. VEGF-C concentration correlated significantly with distant metastasis, but not with lymph node metastasis. The VEGF-C positive group showed a significantly lower 5-year survival rate than the VEGF-C negative group (63.2% vs. 83.5%, p<0.05). The level of VEGF-D negative correlated with lymph node metastasis and mode of invasion. Moreover, we examined expression of VEGF-C,Flt-4,CD34,CD31 and D2-40 for 24 gingival cancers by immunohistochemistry. Both expressions of VEGF-C and Flt-4 did not correlated with lymph node metastasis. There was no relationship between immunohistochemical and serological methods.Conclusion. The serum level of VEGF-C might have potential usefulness as biological marker of OSCC, but it is necessary to confirm relationship between immunohistochemical and serological methods by a larger scale study